Obstetric Cholostasis

Obstetric Cholostasis

1. Signs and Symptoms

   • Dark Urine & Pale Stools
     • Caused by absence of bile that contributes to the usual colour
   • Abnormal Liver Function Tests
     • AST, ALT, GGT, Alkaline Phosphate
     • caused by the condition being a liver disorder
   • Mild Jaundice
     • caused by build up of bilirubin levels
       • Can lead to vit k deficiency
   • Tiredness
     • Can lead to depression
   • Persistent Pruitus (Rash)
     • Caused by raised levels of bile acids
   • Sickness & Poor Apitite
     • Caused by increased bile acid levels
   • UTI's
     • caused by build up of liver enzymes

2. Underlying cause not known, but may have genetic and environmental factors

3. Liver Disorder

4. Implications

   • Maternal
     • Stress
       • Psycological and Physical
         • Caused by intense itching, lack of sleep and fetal concerns
           • Information avaialable from the British Liver trust
     • Gallstones
       • Caused by imbalance of bile make up causing Cholestrol levels to become too high and form stones
     • Malabsorbtion of Vit K
       • 10mg daily from 32wks
     • PPH - increased risk by upto 25%
       • fetal monitoring req: due to fetal distress risk
     • Sleep Deprevation
       • caused by itching
   • Fetal
     • Spontaneous Pre-term birth
     • Mec stained liquor
       • Risk of Fetal aspiration
     • Iatrogenic pre-term birth
     • Sudden IUD/Stillbirth
     • Fetal Distress
     • Bile Acids can cross the placenta
       • can cause 02 deprevation to the fetus due to malfunction